picked q 2, 2010? >> yeah. but if you would draw a line particularly since quarter 2009. it has been pretty stable. yes, you are right but we did have a dry point to reflect a change in population as well as a change in activity to justify the cost. >> okay. thank you. >> on page 20, the city plan per thousand has decreased 10 percent since 2 years ago. again, that was the high point that we picked. what we are

doing if you will looking at the 96 per thousand kaiser 464 at the in point at 62.7. if you noticed as i mentioned earlier, the city plan is not that different in age and male female distribution. so you will notice that the factor one is much closer at 93 percent. you would not expect to see much changes. if you notice the average length of stay is at 5.9. there is about 1.75 spread between high and low and the blue line of skilled nursing is

the most variable of them all of moving on to the cost per day, what you will notice is the current inpatient cost per day is about 62.43. it's an annual cost of 2.5 years. this is not unexpected and quite reasonable trend for this period of time. moving on to page 23. there is nothing as you look at the graph and you will see it pretty flat. the only thing to draw out here is that the growth is about 1.3 percent. there is a slight growth in er rate of 4.6 percent and surgical cost and yet nothing above trend. lastly looking at the procedures per thousand, again, we have the issue of the other 21,000 of the 33778 are other. and we

have to work with uhc to see what goes into that very low dollar area. in the generic drug dispensing is 77 percent. pat yourself on the back. this is a 48 percent increase in dispensing. you've almost doubled it. good job. as far as cost goes, they have gone down which is what you would expect to see in shifts in increase and shifts to generic. the cost per script has decreased 14.9 percent to 104.53 in quarter two. you have the same types of drugs in the actives, however

the diabetic increases are in creasing in dollars. in summary what we'll bring to you is information to consider. the city plan's healthful and sustain able retirees. it's not sustain able as it is. we recommend the hs board consider several options for the future of the active and early retiree pool. one is move the pool with medicare retirees. the second would be to close the active city plan to all employees other than those outside the kaiser and blue shield service areas such as the heche but very small. third we ask and

investigate the policies to make the changes to the active plan to draw more people into it to make the plan affordable again. howevercious that does have a down side that it might cause increase rate in population which is a higher volume than the uhc plan. what i want to say these are the consideration we have and they can all concur as individuals or in groups of two or three of the options if you want. so with that, i would entertain any questions that you may have. >> mr. scott? >> i wanted to go back to your slide 26. you identified for early retirees with diabetes is kind of a therapy that is impacting cost. are you seeing a similar trend around the things around cardiovascular

disease related issues? >> when i looked at the top drugs i did not see a repeat, you have the stat ins but because of diabetes you have the insulin that is not all generic and that's where the cost accrue. >> they are present in this? >> they present but not enough to overall impact your drugs >> over time we should be able to anticipate that that would be kind of an outgoing outcome with this population. >> as the population ages one would see cardiac increases. >> all right. so these are three suggestions that everyone take a look at for some other meeting? >> exactly. >> thank you for your presentation. >> could we take a short break

at the request of the board members. >> thank you so much. >> 10 minutes.@@úúúúppxxxx÷÷ >> i'm asking for public comment on no. 10. item 11. any discussion. >> item 12. item to put items

on future agenda. >> any public comment on this item? >> sorry. i don't understand. still working on this. >> commissioner fraser. wiener and mar. >> my suspicion is that it will take a while and whose bill it will make it out. to be clear, it's nothing but unclear now. i

will keep everyone updated for sure. >> all right. item no. 13. >> the clerk: item 13, discussion item, opportunity for the public to comment on any matters within the boards jurisdiction. >> commissioners, just one quit note while i'm not hard of hearing is that you don't speak directly into the microphone and especially commissioner fraser, we can rarely hear almost all of what you say and it gets lost and you swallow the end of your sentences. after many years. too many years of speech and forensics. commissioner, it's great because we hear everything that you say. i would ask you all to

please speak directly into the microphone. we have members who regularly wear hearing aids and we have difficulty understanding what goes on and the commission secretary is right on with her comments. everything she says can be heard. thank you. >> thank you. >> commissioners, dennis krueger active and retired firefighters. on behalf of the firefighters i would like to say hello to catherine and hope that you will all our prayers are going well for you. i have heard a couple things today that kind of fall into that wheel house. supervisors of san francisco have passed a wellness resolution. i think that's wonderful. they are

doing research into transparency and cost and hospitals. one of the things that comes up is causes of waste is inadequate primary and preventative care and that's what i'm here to talk about. dental. the most basic preventative care that we have in our society. and our dental program lacks. specifically among retirees who need it the most. i think of a wisdom tooth that gets infected and a person that can't pay or hasn't got the money to have it taken out. that leads directly to heart disease. what is cheaper to abstract an abscessed tooth or have a heart operation. preventative care includes

dental. so i'm looking forward to work with lisa, the deputy director regarding looking into our dental plans and hopefully at least bring retirees up to what the active people are receiving and hopefully increase that for everybody. i was in europe earlier this year, i cracked a tooth. i went into a dentist in switzerland, he looked at it, checked it out and told me what to do and i went in for a price, don't worry about it. it's taken care of. almost every health plan in europe of the industrialized nations there include dental. if we want to make people healthier, we have to improve their dental. thank you. >> thank you. any other public

comments. no comments? item no. 14. >> the clerk: item 14, action item vote on whether to hold closed session to discuss the members appeal has been canceled, so member account overpayment. president? >> all right. i will need a recommendation. >> i move we go into closed session to discuss the item referenced. >> second. >> okay. any public comment on this. all in favor say, "aye". >> aye. >> all those opposed? right. we'll now be in closed session. disclose information regarding machine account overpayments. >> i move that we do not

disclose member information. >> second. >> all in favor say, "aye". >> aye. >> opposed? okay. now we have no. 18. >> the clerk: action item, possible report on action taken in closed session regarding member account overpayments. >> all right. all in favor say, "aye". >> aye. >> opposed? all right. if without any objection, this meeting is adjourned. [ meeting is adjourned ]

>> this is a meeting of the san francisco recreation and park commission. would the secretary please call the really

>> (calling names) so we are on item it which is the president report and just as a quick remainder please please silence all electronic devices. that would go 0 off and commissioner buell. >> 3 minutes. >> you'll have 3 minutes to comment on the president reports. >> briefly for those of you who were at the operations committee we don't have the tower scheduled at today's committee meeting because the two commissioners thank you. i'm having a senior momentum and i spent some time with the staff

and community looking at the various options and hoping we can explore others in december. the other item the swab championship at harding was done with great success so an applause to the staff tom and nick and other is and to the gardeners that do such an exiled job the course was a 10 and wanted to see more activity and more consolidation at the course because he thought to was world-class and that's coming from 9 people that use it. so with that that clocks my president report >> anyone who wants to make. >> prayer by the chaplain. >> under the president report. >> seeing none, public comment is closed. and we're on item number 3 the

general manager's report >> here. thank you, commissioner in the spirit of brief commission president's report and the brief committee agenda i too am going to try something different and be briefer let the record reflect that. with the holiday season approaching i want to talk about some winter celebrations and other news from your parks. happy thanksgiving tomorrow night and recreation center our staff is going to are a rec and park feptd and our fourteenth cook off turkey fenlt we're going to have a intuition

contest this is every bit as exciting and drastic as that show. every year our staff out do themselves and i urge everyone to attend and get an early taste of the holiday. then if that isn't enough help us with o our light tree lighting and reeshts and a visit from the guy in the red suit. it's going into one are our popular events we have several folks come out and it's more exciting and there's a great tradition here. this was started by john mcclaren who started lighting trees that ended in front of

mcclaren lodge that were so the event thursday december 5th. (noise). microphone noise >> must have been santa claus. >> keep going phil. >> so, anyway that holiday tree thing 6 that p.m. a brief announcement about our community capital teams r is about halfway through our workshop that's 2012 those diverse our park folks a chance to make a different.

attend dance is 4 mandatory for all community fund applicant. the next workshop is december 5th at the jolie work center watch this on the sf website. as we approach thanksgiving it's not too soon to start thinking about basketball it begins december 5th registration for our popular baseball legacy and our fire department begins department december 5th boys and girls are inadmissible to join and pitches report in february and log onto rec online to sign you been. to two quick presentations and then our video.

today is matt. we're joined by matt and want to report that the 2013 park alliance party was a great success we had 5 hundred people that showed their support by attending and it was held at the golden gate park and i want to thank all the commissioners who showed up. i want to give a big shout it out to the park alliance for doing the aesthetics it was quite wonderful and a fun event and most significantly the proceeds are going to benefit our parks in san francisco. and matt can come up the parks and alliance got $50,000 to the

renovation this year is - the park alliances is 2rib thai thousand dollars to the department to fund a variety of the small projects that happen throughout the year and 5 thousand dollars for camp for the summer for sdbltd folks. i want to thank matt and their entire staff. matt if the president to say something please do >> nevertheless to say we're delighted with the financial impacts it will have and your especially delighted to see the parks and alliance to help open the international airport at the jet place structure can be

installed there. we're delighted to make that contribution and making many more. >> thank you matt. this year was the 30th anniversary of the conservatism core and it's been an amazing partner of this department and for the city it was 0 started in 1983 by feinstein. it was to teach our children job ready in essence and helping them to understand the land. they've been a fantastic partner and in recognition of their 30th anniversary and all the amazing work we don't talk about we do with the san francisco conservatism core i want to bring up a colleague to make a

short presentation about this presentation >> thanks phil. good morning, commissioners. many of you know b about the sf cc but i'm going to make a presentation we were founded in 83 with mayor feinstein and the primary purpose is to serve protecting 18 to 26-year-old folks. all our young people come voluntarily to our program who want to have a better future. the program we provide we provide a charter high school job readiness and career demonstrate services and case management and one year of posting program support to make sure their post core is

successful and the second puff purpose is to provide high quality environment work such as the rec and park to name a few. with regard to rec and park we've enjoyed a relationship and we've installed structures at the gilman playground and ralph playground and hertz playground to name a few and provided community garden development and trail maintenance in glen common and berry no heights and all of those were done with various mechanisms. however, we bring money to the table. so finally, from 19 to the perpetrate sf cc has provided $1.4 million of the property 84 funding we received from the

state to remove and rebuild remaining walls and this in the buena invest and adams rogers just to name a few. at the conclusion we having ask the rec and park fill out an evaluation for the core member performance and the overall quality of the project. for the future we want to partner with rec and park to get some funding forbid the rec and parks trail fund and others. in some cases the application will be more competitive if you use the core as a partner to perform the work >> thank you for your time and attention i want to show you a 5 minute video of our anniversary and some folks to say a few

brief words about the projects they've worked on if that's okay. >> that's okay. >> i'm a nerd when it comes to computers. >> this is a rough neighborhood as we were 2k3wr0u7 as kids they therapist going to be in jail or on drugs. i didn't think i would have a job i might do this when i'm trying i want to stay open the streets until my time is up. >> i struggle in learning but you once i hit high school i gave up, you know. >> what was it like it was not

all that happy so i decided one day to get up and bought me to the core. >> i decided to stop acting like a child and be a man. >> up. >> up. >> down. >> down. >> oh, man what did i get myself into. >> i have to wake up aaron four or five to get her at the 7. >> wake up at what time oh, no, this isn't for me. >> i started getting used to it arrest. >> they're the ones that started to want to change their life they're not forced to be here. >> it makes you want to be more

responsible, you know, basically, it, you know, you get farther than you thought you could. >> if you raise the bar people reach it. >> i'm the second one in my family to receive a high school diploma 80 so i want to change the kindly. >> in order to change the pathway instead of a job you need a foundation of education. >> they give a handout you have to reach. >> work hard. >> this is to help me grow so i'm more ready to deal with real life. >> it helps you to bring down the barriers no. your life. >> yesterday wasn't a good day to n be in school. >> peo